Hepatitis C treatment: timeline for people with HIV

HCV treatment timeline for HIV-positive people

Week 4
After 4 weeks treatment check hepatitis C viral load (HCV RNA) for a rapid virological response (RVR: undetectable HCV viral load). This is mainly still a research test.

RVR is a good predictor of SVR. Continue treatment.
No RVR: continue treatment, because it is too soon to predict how you are likely to respond.

Week 12
After 12 week check HCV viral load for Early Virological Response (EVR: either a 99% drop in HCV viral load or an undetectable result).

EVR: Continue treatment
No EVR: Stop treatment because SVR is VERY unlikely (94%-100% of people in trials with no EVR had no SVR). If you have serious liver damage, you and your doctor may decide to try interferon maintenance therapy. This is where you treat to delay or stop HCV progression, rather than to clear HCV. Some doctors may suggest using daily consensus interferon, but there has only been one based on one small study of this in HIV-positive people.

Week 24
Check HCV RNA at week 24. If undetectable, continue treatment according to genotype

Week 24, 48 or 72
Check HCV viral load when you stop treatment, for End-of-Treatment Response (ETR: undetectable HCV viral load).

If HCV is detectable, consider repeating test. Stop treatment if the second result is also detectable. If you have serious liver damage, you and your doctor may decide to try maintenance therapy (see above).

Week 48, 72 or 96
Check HCV RNA six months after finishing treatment for sustained virological response (SVR: undetectable HCV viral load).

If you are undetectable, you have cleared your HCV.
If HCV viral load is detectable, treatment has not cleared your HCV. It still may have improved the condition of your liver.

This is the web edition of the i-Base guide Hepatitis C for people living with HIV: testing, coinfection, treatment and support. This guide is available in UK clinics. You can order free printed copies or download a PDF version (657 Kb).

Information on this website is provided as a guide only. All treatment decisions should be taken in consultation with your doctor or other healthcare professional. Authors and credits. Full section index. Glossary.